Hemolytic uremic syndrome

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    • Thrombotic thrombocytopenic purpura (TTP))
      • A hemolytic anemia that results from deposition of abnormal vWF multimers into microvasculature.(MCQ)
      • This is a life-threatening emergency!
      • Etiology
        • Infection (especially HIV and E. coli 0157:H7) .(MCQ)
        • Malignancy
        • Drugs (antiplatelet agents, chemotherapy agents, contraceptives) .(MCQ)
        • Autoimmune disorders
        • Pregnancy .(MCQ)
      • Signs and symptoms
        • Fever
        • Altered mental status (waxing and waning, depending on location and movement of clot) .(MCQ)
        • Renal dysfunction (hematuria, oliguria)
        • Thrombocytopenia—can be mild to severe
        • Microangiopathic hemolytic anemia.(MCQ)
      • Diagnosis
        • Evidence of hemolysis:
          • Schistocytes on peripheral smear
          • decreased haptoglobin.(MCQ)
          • elevated LDH.(MCQ)
          • elevated total bilirubin
        • Renal failure: Elevated BUN, creatinine
        • Fever, confusion.(MCQ)
        • Normal PT and PTT (Most important MCQ)
      • Treatment
        • Do not transfuse platelets. .(MCQ)
        • Plasmapheresis is mainstay of treatment (given daily, until platelet count rises to normal). .(MCQ)
        • May give FFP if plasmapheresis not available.(MCQ)
      • Clinical Pearls :
        • E. coli 0157:H7 is an invasive gastroenteritis resulting in hemolytic uremic syndrome (HUS). .(MCQ)
        • HUS differs from TTP in severity and lack of neurologic symptoms. .(MCQ)
        • Diagnostic pentad for TTP: .(MCQ)
          • Fever
          • Anemia
          • Thrombocytopenia
          • Renal dysfunction
          • Neurologic dysfunction
        • Transfusing platelets in TTP is thought to “fuel the fire” and exacerbate consumption of platelets and clotting factors, resulting in more thrombi in the microvasculature. (MCQ)


    aHUS animation
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    TTP-HUS Overview
    A brief, basic and animated overview of the mechanism and treatment of TTP-HUS.
    Hemolytic-Uremic Syndrome [Nelson Pediatrics Audiobook]
    This is an audio version of the famous pediatrics textbook “Nelson Textbook of Pediatrics, 19th Edition”. Many students find it much easier to listen than to read something. Such students will find this very useful.

    Some tips:
    – Listen to this while reading, to maintain concentration
    – You can download this as mp3 using Snipmp3.com
    – Use audiobook apps for iPhone and Android for convenient listening
    How to pronounce Hemolytic-uremic syndrome
    Learn how to pronounce Hemolytic-uremic syndrome and use in a sentence.
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